DESCRIPTION : University of Miami Vision Loss Prevention Translational Research Center Vision problems are among the top ten conditions responsible for disability in the US population and approximately half of severe visual impairment is preventable via early detection and treatment. The Centers for Disease Control and Prevention has launched the Vision Health Initiative (VHI) to develop a coordinated national public health framework to address the growing burden of ocular disease and disability in the US. The University of Miami Ocular Epidemiology Research Group (UM-OERG), which has a long-standing interest in health disparities research, is a joint partnership between the Departments of Ophthalmology and Epidemiology, as well as the Bascom Palmer Eye Institute (BPEI), which is consistently rated as one of the nation's best ophthalmic hospitals in the US. The UM-OERG, which includes epidemiologists, heath services researchers, health policy experts, ocular clinician-scientists, biostatisticians, and community health researchers will focus on local underserved populations, (including Hispanic, African-American, and Haitian- American), to evaluate system-level and individual-level factors which enhance and impede access to high quality and cost-effective ocular health care. Four projects are proposed, all in adults 40 years of age and older, which will be modified as necessary in year one in order to develop common metrics across the Translational Research Centers (TRCs); in addition a proposed TRC Network Study is listed: 1) Undertake comprehensive analysis of BPEI medical and billing records to determine treatment patterns for patients with the following disabling ocular conditions: age-related macular degeneration (AMD), cataract, diabetic retinopathy, and open-angle glaucoma, as a function of insurance status, insurance type, ocular diagnosis, and patient socidemographic characteristics; 2) Develop and administer health care provider surveys including all Bascom-Palmer ophthalmologists, optometrists, and select ancillary medical personnel, community ocular care providers, and primary care healthcare providers throughout Miami-Dade County with an emphasis on medically underserved areas, in order to assess ocular treatment and referral practices, knowledge of and counseling for risk factors for visual disorders in their patient populations, and barriers to the optimal treatment of ocular conditions; 3) Develop and administer waiting room surveys of BPEI ocular patients as well as in select community ocular care clinics; 4) Develop and undertake community-based surveys of adults residing in medically underserved populations in Miami-Dade county; and 5) Propose a TRC Network Study which will utilize a systems-approach to integrate and implement into primary care and ocular tertiary health care, clinical practice guidelines for smoking cessation. Research findings will be disseminated locally to targeted underserved populations health care providers via our established UM Health Disparities Outreach Core, and across TRCs via stakeholder meetings in order to inform behavior change and health care practices designed to improve population-level vision health.